Migraine in women with chronic pelvic pain with and without endometriosis
Barbara Illowsky Karp1, Ninet Sinaii, Lynnette K Nieman
1National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1109, USA.
Objective:
To examine the prevalence of migraine in women with chronic pelvic pain with and without endometriosis.
Design:
Prospective study of headache, pelvic pain, and quality of life before laparoscopic surgery for pelvic pain. Endometriosis was diagnosed pathologically. Headaches were classified as migraine or non-migraine using International Headache Society criteria.
Setting:
Clinical research hospital.
Patient(S):
108 women in a clinical trial for chronic pelvic pain (NCT00001848).
Intervention(S):
Laparoscopy to diagnose endometriosis, assessment by neurologist to assess headaches.
Main Outcome Measure(S):
Prevalence of migraine and other headaches in women with chronic pelvic pain with or without endometriosis. Headache frequency, severity and relationship to pelvic pain and endometriosis.
Result(S):
Lifetime prevalence of definite or possible migraine was 67% of women with chronic pelvic pain. An additional 8% met criteria for possible migraine. Migraine was no more likely in women with endometriosis than those without. Women with the most severe headaches had a lower quality of life compared with those with pelvic pain alone.
Conclusion(S):
Migraine headache is common in women with chronic pelvic pain, regardless of endometriosis, and contributes to disability in those with both conditions. The strong association suggests a common pathophysiology.
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